Committed to Junction City

The state’s new mental hospital is drawing fire—and it hasn’t even been built yet.

WATERCOLOR WONDER: Advocates are flummoxed that the state of Oregon’s plans for a new mental health hospital in Junction City include cutting all commitment beds in the Portland area and east of the Cascades. - IMAGE: junctioncityoregon.gov

The road for the Oregon State Hospital in Junction City
stretches across an open field, waiting to lead people to the state’s
newest mental health facility.

State officials have
spent $61.8 million preparing the land in the Lane County town 15 miles
northwest of Eugene. New water and sewer lines run to the site.

But as with the road, so far they lead nowhere.

There’s no new hospital in Junction City yet. And many mental health advocates want to keep it that way.

Gov. John Kitzhaber’s
proposed 2013-15 budget calls for borrowing $79.4 million to build the
hospital, which is already two years behind its original schedule.

Oregon has been
undergoing a major effort to bring its mental health system into the
modern age. The Oregon State Hospital, built in 1883, in Salem was
literally crumbling when the state tore it down.

In its place, legislators approved $458 million for a new 620-bed hospital in Salem, intended to leave behind the days of One Flew Over the Cuckoo’s Nest.

But plans for the
second hospital in Junction City are perhaps the least-known—and
least-scrutinized—part of the state’s strategy.

And mental health
advocates say building it would add the wrong kind of treatment beds in
Oregon, taking the state in the opposite direction from where it should
go: toward smaller, less-expensive facilities located near
high-population areas—including Portland.

If the Junction City
hospital opens (scheduled for 2015), the state would close a 90-bed
state hospital campus in Portland and the 60-bed Blue Mountain Recovery
Center in Pendleton. Blue Mountain and Portland accept civil
commitments, people who pose a danger to themselves or others, not
forensic patients, who have been found not guilty of crimes by reason of
insanity.

That would leave the
state without civil mental health facilities east of the Cascades and no
beds in the Portland area, which accounted for nearly half of the
state’s civil commitments last year

“We don’t do that for
any other health condition,” says Chris Bouneff, executive director of
the National Alliance on Mental Illness of Oregon. “Imagine your loved
one had a stroke and had to go into some long-term rehabilitation care
and was from Portland, and we sent them to Junction City two and a half
hours away.”

Linda Hammond,
interim director of addictions and mental health for the Oregon Health
Authority, says the Junction City hospital is necessary to replace the
outdated Pendleton facility. The lease for the Portland branch expires
in 2015.

Hammond says her
agency wants smaller, locally based facilities, but they would take more
time to set up than the state has. She estimates establishing a network
of community-based care will take years.

“We can’t suddenly
close Blue Mountain and Portland and put those people out on the street
if there is not the infrastructure and services to meet their needs,”
she says.

The U.S. Department
of Justice has put pressure on the state to move away from larger
hospitals, so in 2010 state officials cut the capacity of the proposed
Junction City hospital to 174, from its original 360.

Overall, the new hospital would add just 22 beds to the state’s mental health system, Hammond says.

The long-term plan,
she adds, is to hand over the Junction City facility to the state
Department of Corrections, which owns the site.

Bouneff and other opponents say they’re skeptical that will ever happen.

He says smaller
facilities of 16 or fewer beds in locations across the state would save
money, allow the state to collect Medicaid reimbursements that it can’t
with a large hospital, and keep patients nearer their homes.

The lack of good
reasons to build a big, new hospital so far from Portland, he adds, has
led him to one conclusion: “This is pork, pure and simple.”

The Junction City
hospital would bring about 2,500 construction jobs to Oregon’s economy
and 500 to 600 sustained jobs once it opens, says state Rep. Val Hoyle
(D-Eugene), whose district includes the hospital site.

But to call it pork for her district is “insulting and wrong,” Hoyle says.

The governor’s
budget, she points out, includes $1 billion for community mental health
and addictions treatment—a 43 percent increase fromthe current budget.

Hoyle calls the plans
“80 percent” of what advocates want. “If I didn’t think that this was a
necessary part of our mental health system, then I wouldn’t be fighting
for it,” she adds.

Kitzhaber and Democratic legislative leaders want to approve the hospital.

Despite their
backing, Rep. Carolyn Tomei (D-Milwaukie), chairwoman of the House Human
Services and Housing Committee, says the high costs of doubling down on
larger institutions rather than providing community care could give
lawmakers pause.

“It could be stopped
if enough of a swell of the population says, ‘Wait, this doesn’t make
sense,’” Tomei says. “But I don’t think it will happen.”